Surgical stapling apparatus with clamping assembly

ABSTRACT

A surgical stapling apparatus includes a handle assembly and an elongate portion extending distally from the handle assembly. An end effector disposed adjacent a distal portion of the elongate portion includes an anvil assembly and a cartridge assembly, wherein at least one of the cartridge assembly and the anvil assembly is movable with respect to the other to move the end effector between an open configuration where the cartridge assembly and the anvil assembly are substantially spaced and a closed configuration where the cartridge assembly and the anvil assembly are closer together. The end effector also includes a clamping assembly including a first clamping surface deployable to extend laterally from the anvil assembly, and a second clamping surface deployable to extend laterally from the cartridge assembly such that, when deployed, the first and second clamping surfaces oppose one another when the cartridge assembly is in the closed position.

BACKGROUND

1. Technical Field

This application relates to a surgical stapling apparatus. Moreparticularly, this application relates to a surgical stapling apparatusthat includes structure for clamping tissue.

2. Related Art

Surgical stapling or fastener-applying devices for joining tissue arewell known. Typically, such devices include an opposing jaw structurefor grasping and clamping selected tissue, wherein one of the jaws ofthe opposing jaw structure includes a cartridge housing a plurality ofstaples or fasteners and the other jaw includes an anvil for formationof the fasteners.

Certain surgical stapling devices, for example, include two elongate jawmembers for forming staples in generally linear rows. A cartridgecontaining staples arranged in two or more linear rows forms a tissueengaging surface of one of the jaw members, and an anvil havingcorrespondingly arranged staple forming pockets forms an opposing tissueengaging surface of the other jaw member. The jaw members may beapproximated to clamp the targeted tissue between the two tissueengaging surfaces. Thereafter the staples may be ejected from thecartridge toward the staple forming pockets to form rows of staples inthe targeted tissue.

While employing a surgical stapler or similar device, a surgeon mayexperience difficulty while clamping tissue that is relatively thick;unduly strenuous effort may be required. To mitigate this difficulty, asurgeon will often pre-compress relatively thick tissue with a clampprior to introducing the stapler, or apply clamps to adjacent tissue inconjunction with the stapler. These procedures require extra steps anddevices and can be time consuming and expensive especially duringendoscopic procedures.

SUMMARY

The present disclosure relates to a surgical stapling apparatusincluding a handle assembly, an elongate portion extending distally fromthe handle assembly and an end effector disposed adjacent a distalportion of the elongate portion. The end effector includes an anvilassembly including a fastener forming surface thereon and a cartridgeassembly including a fastener ejection surface thereon through whichsurgical fasteners may be ejected. At least one of the cartridgeassembly and the anvil assembly is movable with respect to the otherbetween an open position wherein the cartridge assembly is substantiallyspaced from the anvil assembly and a closed position where the cartridgeassembly and the anvil assembly are closer together. The end effectoralso includes a clamping assembly including a first clamping surfacedeployable to extend laterally from the fastener forming surface of theanvil assembly, and a second clamping surface deployable to extendlaterally from the fastener ejection surface of the cartridge assemblysuch that, when deployed, the first and second clamping surfaces opposeone another when the cartridge assembly is in the closed position.

A portion of the first clamping surface may be deployable to extenddistally from the fastener forming surface of the anvil assembly. Aportion of the second clamping surface may be deployable to extenddistally from the fastener ejection surface of the cartridge assembly.

The clamping assembly of the surgical stapling apparatus may furtherinclude at least one fluid reservoir operatively associated with atleast one of the first and second clamping surfaces such that a fluidmay be introduced into the fluid reservoir to deploy the first andsecond clamping surfaces. An outer surface of the fluid reservoir may beflexible, and also the clamping assembly may include distinct first andsecond fluid reservoirs operatively associated with the first and secondclamping surfaces respectively, such that the first and second clampingsurfaces may be deployed independently.

The first clamping surface of the clamping assembly may define agenerally U-shaped perimeter. Also, at least one of the first and secondclamping surfaces may include a wound treatment material.

The present disclosure also relates to a surgical apparatus formanipulating tissue. The apparatus includes a handle assembly, a tubularelongate portion extending distally from the handle assembly andincluding a fluid conduit extending at least partially therethrough. Anend effector is coupled to a distal end of the tubular elongate portion.The end effector includes a pair of jaw members configured to movebetween an open configuration for receiving tissue and a closedconfiguration for clamping the tissue between a pair of clampingsurfaces on the jaw members. Also, the end effector includes a fluidreservoir in fluid communication with the fluid conduit, wherein thefluid reservoir is inflatable to increase an effective clamping surfacearea of the jaw members.

The present disclosure also relates to a loading unit for use with asurgical stapling apparatus. The loading unit includes a proximal bodyportion configured for engagement with a portion of the surgicalstapling apparatus, and an end effector disposed adjacent to a distalportion of the proximal body portion. The end effector includes an anvilassembly and a cartridge assembly wherein at least one of the cartridgeassembly and the anvil assembly is movable with respect to the otherbetween an open position wherein the cartridge assembly is substantiallyspaced from the anvil assembly and a closed position where the cartridgeassembly and the anvil assembly are closer together. The end effectoralso includes an inflatable clamping assembly configured for deploymentfrom each of the anvil assembly and the cartridge assembly, wherein theinflatable clamping assembly is in fluid communication with the proximalbody portion to receive a fluid.

The proximal body portion may be configured to establish fluidcommunication between the loading unit and the surgical staplingapparatus upon engagement of the proximal body portion with the surgicalstapling apparatus. Alternatively, the inflatable clamping assembly maybe in fluid communication with a lateral opening in the proximal bodyportion.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and form part ofthe specification, illustrate embodiments of the present disclosure whenviewed with reference to the description, wherein:

FIG. 1A is a perspective view of a surgical stapling apparatus inaccordance with the present disclosure including a handle assembly andan end effector with an anvil assembly in a closed position;

FIG. 1B is a cross sectional view of the handle assembly of FIG. 1A;

FIG. 1C is a cross sectional view of the end effector of FIG. 1Aengaging tissue in a pre-firing configuration wherein staples arearranged within a cartridge assembly of the end effector;

FIG. 1D is a cross sectional view of the end effector of FIG. 1C in apost-firing configuration wherein the staples are ejected from thecartridge and deformed within the tissue;

FIGS. 1E, 1F and 1G are schematic views of an articulation mechanism ofthe apparatus of FIG. 1 in various articulated positions;

FIG. 2A is an enlarged perspective view of the end effector of FIG. 1Awith the anvil assembly in an open position and depicting a clampingassembly in a undeployed configuration;

FIG. 2B is a perspective view of the end effector of FIG. 2A depictingthe clamping assembly in a deployed configuration;

FIGS. 2C and 2D are perspective views of the end effector of FIG. 2Adepicting the clamping assembly in alternate deployed configurations;

FIG. 3 is a plan view of a clamping surface of the anvil assembly ofFIG. 2B;

FIG. 4 is a plan view of an alternate embodiment of a clamping surfaceof an anvil assembly in accordance with the present disclosure;

FIG. 5 is a partial transverse cross-sectional view of the anvilassembly of FIG. 3;

FIG. 6 is a partial transverse cross-sectional view of an alternateembodiment of an anvil assembly in accordance with the presentdisclosure;

FIG. 7 is an exploded perspective view of the surgical staplingapparatus of FIG. 1 depicting a loading unit separated from an elongateportion of the surgical stapling apparatus;

FIG. 8 is a schematic view of the loading unit and elongate portion ofFIG. 7 in an engaged configuration;

FIG. 9 is a perspective view of an alternate embodiment of a loadingunit in accordance with the present disclosure; and

FIG. 10 is a perspective view of an electrosurgical apparatus inaccordance with the present disclosure.

DETAILED DESCRIPTION

Embodiments of the presently disclosed surgical stapling apparatus aredescribed in detail with reference to the drawings, in which likereference numerals designate identical or corresponding elements in eachof the several views. As used herein the term “distal” refers to thatportion of the surgical stapler, or component thereof, farther from theuser while the term “proximal” refers to that portion of the surgicalstapler or component thereof, closer to the user.

Referring initially to FIG. 1A, a linear surgical stapling apparatusequipped with a clamping assembly in accordance with the presentdisclosure is depicted generally as reference number 10. The apparatus10 includes a handle assembly 12 near a proximal end, an end effector 16near a distal end and an elongate portion 18 therebetween. The endeffector 16 may be positioned within a body cavity to engage tissue at asurgical site while handle assembly 12 is manipulatable by a surgeonfrom outside the body cavity to control the movement and operation ofthe end effector 16. Elongate portion 18 defines a longitudinal axisA-A. The apparatus 10 is inserted into the body cavity through a cannula(not shown) or other suitable introducer for use in endoscopic surgery.

End effector 16 includes a cartridge assembly 20, which houses aplurality of staples “s” (FIG. 1C) arranged in linear rows, and an anvilassembly 22 for forming the staples. At least one of the cartridgeassembly 20 and the anvil assembly 22 is movable with respect to theother between an open position (see FIG. 2A) wherein the cartridgeassembly 20 is substantially spaced from the anvil assembly 22 and aclosed position (FIG. 1A) where the cartridge assembly 20 and the anvilassembly 22 are closer together. A pivotable trigger 24 of the handleassembly 12 is movable through an actuation stroke or strokes relativeto a stationary grip member 28 to move cartridge assembly 20 in relationto anvil assembly 22 between the open position and the closed positionand to eject the staples from cartridge assembly 20.

As depicted in FIG. 1B, handle assembly 12 includes a handle mechanismH100 for actuating the end effector 16. The handle mechanism H100includes a pivot pin H102 about which trigger 24 is pivotable relativeto stationary grip member 28. A biasing member such as torsion springH104 biases the trigger 24 away from the stationary grip member 28. Adriving pawl H106 having a rack engagement finger H108 is pivotallyconnected to the trigger 24 about a pivot pin H112. A biasing membersuch as torsion spring H114 urges the engagement finger H108 toward atoothed rack H116 of an actuation shaft H118. The forward end ofactuation shaft H118 receives the proximal end of a control rod 70 (seeFIG. 7), which extends through the elongate portion 18 toward the endeffector 16.

The trigger 24 may be approximated with the stationary grip member 28 todrive the rack engagement finger H108 of the driving pawl H106 distallyagainst the toothed rack H116. The actuation shaft H118 is thus drivenlinearly in a distal direction resulting in a corresponding lineardistal motion of the control rod 70. A locking pawl H120 is pivotallymounted about pivot pin H122 and biased toward toothed rack H116. Thelocking pawl H120 tends to retain the actuation shaft H118 and thecontrol rod 70 in a longitudinally fixed position. A more detaileddescription of the handle assembly of a surgical stapler and theactuation of the stapler is disclosed in commonly-owned U.S. Pat. No.6,953,139 to Milliman et al., the entire contents of which are herebyincorporated by reference herein.

In a linear surgical stapler, for example, end effector 16 may include adrive mechanism D100 as depicted in FIGS. 1C and 1D to deploy staples“s” from the cartridge assembly 20. Drive mechanism D100 includes adrive assembly D102 attached to the control rod 70 to move with thecontrol rod 70. Drive assembly D102 includes a cylindrical cam rollerD104 for engaging a cam surface D106 on anvil assembly 22. As thecylindrical cam roller D104 engages the cam surface D106, the anvilassembly 22 is pressed against tissue “t” as the anvil assembly 22 ismoved to the closed position. The drive assembly D102 abuts an actuationsled D108 such that the actuation sled D108 is driven distally throughthe cartridge assembly 20 by the drive assembly D102. As the actuationsled D108 translates through the cartridge assembly 20, the actuationsled D108 is moved into sequential contact with staple pushers D112. Thegeneral wedge shape of the actuation sled D108 causes the staple pushersD112 to translate vertically in the direction of the tissue “t” whencontacted by the actuation sled D108 moving distally. The verticalmovement of the staple pushers D112 urges staples “s” from the cartridgeassembly 20, through the tissue “t” and against the staple formingpockets 62 (see also FIG. 3) formed in the anvil assembly 22. The stapleforming pockets 62 are shaped to deform the staples “s” such thatadjacent layers of tissue “t” are joined as depicted in FIG. 1D. Thedrive assembly D102 includes a knife blade D114 positioned to follow theactuation sled D108. This arrangement allows the knife blade D114 to cutthe tissue “t” at a longitudinal location where the staples “s” havebeen applied to the tissue “t.”

With reference to FIGS. 1A and 1E-1G, certain surgical staplers includeend effectors that articulate with respect to the longitudinal axis A-A.For example, an articulation lever 32 (FIG. 1A) is pivotable in thedirection of arrows “P” to cause the cartridge and anvil assemblies 20,22 to pivot relative to the axis A-A as indicated by arrows “p.” Thearticulation lever 32 cooperates with a cam member (not shown) togenerate longitudinal motion that is transmitted through the elongateportion 18 to an articulation mechanism A100 as depicted in FIG. 1E. Thearticulation mechanism A100 includes an articulation link A102configured to receive the longitudinal motion as indicated by arrows“L.” The articulation link A102 is equipped with a loop A104 forengaging a projection A106 coupled to a mounting assembly A108. Themounting assembly A108 is coupled to the cartridge and anvil assemblies20, 22 such that pivotal motion in the mounting assembly A108 istransferred to the cartridge and anvil assemblies 20, 22. The mountingassembly A108 is pivotally mounted to a pivot point A110 (depicted inphantom) having a lateral offset from projection A106. The offset causesthe cartridge and anvil assemblies 20, 22 to pivot in a first direction(FIG. 1F) when the articulation link A102 is moved in a distaldirection, and a second direction (FIG. 1G) when the articulation linkA102 is moved in a proximal direction in response to motion of thearticulation lever 32.

Handle assembly 12 is operable to control other aspects of the position,orientation and operation of the end effector 16. For example, rotationknob 30 is operable to rotate the end effector 16 about longitudinalaxis A-A, and return knob 34 is operable to return the control rod 70and drive assembly D102 to a pre-actuated position once the staples “s”have been ejected from the cartridge assembly 20.

A deployable tissue clamping structure can be incorporated into asurgical stapler as described above, or another type of surgicalinstrument. For example, a fluid conduit 38 extends through the elongateportion 18 between the end effector 16 and the handle assembly 12. Aproximal portion of the fluid conduit 38 is depicted in FIG. 1. A fluidmay be injected into the fluid conduit 38 from a fluid source “F” (asyringe, for example) to deploy the clamping assembly 50. As discussedbelow with reference to FIGS. 2A and 2B, the fluid may be injected underpressure such that the fluid travels distally through the fluid conduit38 into the end effector 16. The fluid source “F” may contain air,saline or other fluids suitable for surgical applications. As depictedin FIG. 1, fluid source “F” is a distinct component from the staplingapparatus 10, but a fluid source may alternatively be incorporated intothe interior of the apparatus 10 and/or associated with a controlmechanism (not shown) to cause the fluid to travel distally into the endeffector 16.

Referring now to FIG. 2A, end effector 16 is depicted with the cartridgeassembly 20 and anvil assembly 22 substantially spaced from one another.In this position, tissue may be inserted between a fastener ejectionsurface 42 on the cartridge assembly 20 and a corresponding fastenerforming surface 44 (see FIG. 3) on the anvil assembly 22. The tissue maybe clamped to an appropriate thickness by approximating the cartridgeassembly 20 and anvil assembly 22, and thereafter, staples may beejected from the fastener ejection surface 42 through the tissue to beformed against the fastener forming surface 44. When a surgeonexperiences difficulty clamping the tissue, or anticipates difficulty,the surgeon may deploy the clamping assembly 50.

The clamping assembly 50 includes a first pair of fluid reservoirs 52flanking the fastener forming surface 44 and a second pair of fluidreservoirs 54 flanking the fastener ejection surface 44. As depicted inFIG. 2A, the reservoirs 52, 54 may be maintained in an undeployedcondition such that a lateral width “w” of the end effector 16 may beminimized. Minimizing the lateral width “w” tends to facilitateinsertion of the end effector 16 into a body cavity through a cannula,for example, and may also provide maneuverability in the body cavity tofacilitate proper positioning of the end effector 16 adjacent thetargeted tissue.

The clamping assembly 50 may be deployed to the configuration depictedin FIG. 2B once the targeted tissue is positioned between the cartridgeand anvil assemblies 20, 22, or at any other time the surgeon deemsappropriate. When deployed, the first pair of fluid reservoirs 52 definea first clamping surface 56 (see FIG. 3) extending laterally from thefastener forming surface 44, and the second pair of fluid reservoirs 54define a second clamping surface 58 extending laterally from thefastener ejection surface 42. Deployment of the clamping assembly 50defines a lateral width “W” of the end effector 16 that is greater thanthe lateral width “w” of the end effector 16 with the clamping assembly50 in the undeployed configuration. The clamping surfaces 56, 58 opposeone another when the cartridge and anvil assembles 20, 22 areapproximated such that the end effector 16 may maintain contact with agreater surface area of the targeted tissue than with the clampingassembly 50 in the undeployed configuration. It is envisioned that thisincrease of surface area that is in contact with the targeted tissuefacilitates the manipulation of tissue.

The fluid reservoirs 52, 54 may be configured for collective deploymentsuch that each of the reservoirs 52, 54 is deployed concurrently upon asingle actuation by the surgeon at the handle assembly 12. For instance,each of the reservoirs 52, 54 may fluidly communicate with the fluidconduit 38 such that injection of fluid through the fluid conduit 38fills each of the reservoirs 52, 54 concurrently. Alternatively, thefluid reservoirs 52, 54 may be configured for individual deployment ordeployment in pairs. For example, the first pair of fluid reservoirs 52may fluidly communicate with the fluid conduit 38 while the second pairof fluid reservoirs 54 fluidly communicates with an additional fluidconduit (not shown). This configuration offers an additional degree ofcontrol to a surgeon. For example, a surgeon may deploy reservoirs 52while maintaining reservoirs 54 in an undeployed configuration asdepicted in FIG. 2C. It is also envisioned that the reservoirs 52, 54may be configured to permit deployment of the reservoirs 52, 54 on onelateral side of the end effector 16 while maintaining the reservoirs 52,54 on another lateral side of the end effector 16 in an undeployedconfiguration as depicted in FIG. 2D. The reservoirs 52, 54 can bedeployed as desired to spread the clamping force applied to the tissueand/or accommodate tissue having areas of different thicknesses.

Referring now to FIG. 3, the fastener forming surface 44 of the anvilassembly 22 includes rows of staple forming pockets 62 arranged in rowsto oppose the staples housed within the cartridge assembly 20 (FIG. 1).The first pair of fluid reservoirs 52 extends laterally on opposingsides of the fastener forming surface 44 to define the first pair ofclamping surfaces 56. The clamping surfaces 56 extend in a lateraldirection to define the lateral width “W” as described above, and extendin a longitudinal direction so as to have a sufficient length “l” toflank an entire row of staple forming pockets 62, for example. Thus,lateral support may be provided to tissue adjacent each one of thestaple forming pockets 62.

FIG. 4 depicts an alternate embodiment of an anvil assembly 22 a. Afluid reservoir 52 a extends along two longitudinal sides of the anvilassembly 22 a to flank the fastener forming surface 44 a, and also alonga transverse side adjacent the distal end of the fastener formingsurface 44 a. A clamping surface 56 a thus defines a generally U-shapedperimeter around the fastener forming surface 44 a. A similar clampingsurface (not shown) could be arranged around a corresponding fastenerejection surface to oppose the clamping surface 56 a.

Referring now to FIG. 5, clamping surface 56 is configured to lie flushwith the fastener forming surface 44. Exterior walls of the fluidreservoir 52 may be constructed of a rigid or semi-rigid material tomaintain a generally flat external geometry when inflated or otherwisefilled with a fluid. The pressure of the fluid within the reservoir 52may be varied to exhibit a similar or dissimilar rigidity with respectto the fastener forming surface 44 at the discretion of the surgeon.

FIG. 6 depicts an alternate embodiment of an anvil assembly 22 b. Aclamping surface 56 b is configured to extend to a height “h” above afastener forming surface 44 b. Exterior walls of reservoir 52 b may beconstructed of a flexible material such that the height “h” may bevaried according to the amount or pressure of the fluid applied to thereservoir 52 b. Clamping tissue against the clamping surface 56 b maytend to deform the reservoir 52 b, and may be less traumatic to thetissue as compared with a rigid clamping surface.

The clamping surfaces 56, 58, 56 a and 56 b may be retracted byevacuating and deflating the reservoirs 52, 54, 52 a and 52 b. Fluid maybe actively withdrawn by generating a reduced pressure at the fluidsource “F” (FIG. 1). In this manner, the fluid may be returned to thefluid source “F” under the influence of a suction force. Alternatively,the reservoirs 56, 58, 56 a and 56 b may be evacuated by establishing afluid flow path between the reservoirs 56, 58, 56 a and 56 b and theatmosphere, thus permitting the fluid to vent. Retracting the clampingsurfaces 56, 58, 56 a and 56 b would facilitate removal of the apparatus10 through a cannula, for example.

Any of the clamping surfaces 56, 58, 56 a and 56 b of the presentdisclosure may be constructed to include a wound treatment material. Thematerial forming exterior walls of the fluid reservoirs 52, 54, 52 a and52 b may be impregnated with the wound treatment material, or theclamping surfaces 56, 58, 56 a and 56 b may be coated with the woundtreatment material. Alternatively or additionally, the wound treatmentmaterial can be contained in the reservoir or reservoirs 52, 54, 52 aand 52 b, and deployed therefrom. The reservoir walls can be puncturableor include perforations that allow leakage of the wound treatmentmaterial to apply the material to tissue. The wound treatment materialmay include an adhesive sealant, a hemostat such as a fibrin basedmaterial or a medicament such as a drug, enzyme, growth factor or adiagnostic agent. Many other possible wound treatment materials aredescribed in U.S. Pat. No. 7,455,682, which is incorporated by referenceherein in its entirety.

Referring now to FIG. 7, surgical stapling apparatus 10 is depicted witha loading unit 66 separated from elongate portion 18. The loading unit66 includes the end effector 16 and may be configured as a single useloading unit (SULU) or a disposable loading unit (DLU) as described inU.S. Pat. No. 7,143,924, which is incorporated by reference herein. Theloading unit 66 is releasable from the elongate portion 18 such thatloading unit 66 may be removed and replaced after using the surgicalstapling apparatus 10. In so doing, the drive assembly of the apparatus10 is replaced, and a fresh knife is supplied, whenever the apparatus isre-loaded. Alternatively, the surgical stapling apparatus may include areplaceable stapling cartridge which is re-loaded into the jaws of theapparatus.

The control rod 70 extends through the elongate portion 18. The jawmembers are defined by the cartridge assembly 20 and the anvil assembly22. Also, fluid conduit 38 extends through the elongate portion 18 suchthat the reservoirs 52 and 54 may be deployed to increase an effectiveclamping surface area and apply pressure to tissue adjacent the jawmembers as described above.

Loading unit 66 includes a proximal body portion 72 configured forengagement with the elongate portion 18. Engagement of the elongateportion 18 and the proximal body portion establishes an operableconnection between the control rod 70 and the drive assembly thatinteracts with the cartridge assembly 20 and anvil assembly 22.Connection of the loading unit also establishes fluid communicationbetween the fluid conduit 38 and the reservoirs 52 and 54.

Referring now to FIG. 8, the loading unit 66 includes a fluid conduitportion 38 a. When the loading unit 66 is connected with the elongateportion 18 of the apparatus 10, a substantially fluid-tight connectionis established between the fluid conduit portion 38 a and the fluidconduit 38 by a quick-disconnect or other mechanism. The fluid conduitportion 38 a extends distally to fluidly communicate with reservoirs 52,54. The loading unit 66 may engage the elongate portion 18 with abayonet, quarter-turn, or similar mechanism requiring both longitudinaland rotational movement between the two components 66, 18. Thus, thefluid conduit portion 38 a, fluid conduit 38 or the connectionestablished therebetween may be sufficiently flexible to accommodate therelative motion associated with the connection of loading unit 66 andthe elongate portion 18.

Referring now to FIG. 9, a loading unit 66 a is configured for use witha surgical stapling apparatus (not shown) that does not necessarilyinclude a fluid conduit extending through an elongate portion. Loadingunit 66 a includes a fluid conduit portion 38 b extending between anopening 38 c in a proximal body portion 72 a of the loading unit 66 aand a clamping assembly 50 a. The proximal body portion 72 a is longenough and the opening 38 c is positioned sufficiently proximally suchthat when the loading unit 66 a is inserted into a cannula, the lateralopening 38 c is exposed (i.e., located proximally of the cannula) topermit introduction of a fluid from a fluid source “F” (FIG. 1). Asyringe, for example, may be provided as fluid source “F.” A syringepermits fluid to be introduced under pressure through the lateralopening 38 c, through fluid conduit portion 38 b, and into clampingassembly 50 a to deploy the clamping assembly 50 a. Once the clampingassembly 50 a has been deployed, the syringe permits evacuation of thefluid from clamping assembly 50 a. The clamping assembly 50 a may thusbe deployed and retracted even when the loading unit 66 a is coupled toa surgical stapling apparatus devoid of a fluid conduit extendingthrough an elongate portion.

Many components of surgical stapling apparatus 10 are substantially asdescribed in U.S. Pat. No. 6,669,073, which is incorporated herein inits entirety by reference. It is contemplated that the presentlydisclosed clamping assembly may be used in association with other knownstapling devices of both endoscopic and open construction. These devicesinclude articulating and non-articulating devices as well as reusableand non-reusable devices. Examples of such devices are disclosed in U.S.Pat. Nos. 6,202,914 and 6,250,532, which are also incorporated herein intheir entirety by reference.

Referring now to FIG. 10, an electrosurgical apparatus 100 may alsoembody various aspects of the present disclosure. Electrosurgicalapparatus 100 includes a connector assembly 110 for connection to asource of electrosurgical energy (not shown). The use of anelectrosurgical apparatus to apply electrosurgical energy to tissue isgenerally described in U.S. Pat. No. 7,083,618, which is incorporatedherein in its entirety by reference.

Electrosurgical apparatus 100 includes a handle assembly 112 near aproximal end, an end effector 116 near a distal end and an elongateportion 118 therebetween. The end effector 116 may be positioned withina body cavity to engage tissue at a surgical site while handle assembly112 is manipulatable by a surgeon from outside the body cavity tocontrol the movement and operation of the end effector 116. Handleassembly 112 includes a movable handle 124 a, which may be manipulatedto open and close the end effector 116, and a trigger 124 b, which maybe manipulated to initiate an electrosurgical current.

A fluid conduit 138 extends from the handle assembly 112, throughelongate portion 118 to a clamping assembly 150 at the end effector 116.Thus, a fluid may be injected into the fluid conduit 138 from a fluidsource “F” (FIG. 1) from outside the body to deploy the clampingassembly 150 within a body cavity. The clamping assembly 150 includes apair of reservoirs 152, 154 in fluid communication with the fluidconduit 138. The reservoirs 152, 154 may be filled with the fluid toextend laterally from tissue engaging surfaces of the end effector 116as depicted in FIG. 10. This increases an effective clamping surfacearea of the end effector 116. The clamping assembly 150 may beundeployed by evacuating the reservoirs 152, 154 for insertion andwithdrawal of the end effector 116 through a cannula, for example. Itwill be understood that various modifications may be made to theembodiments disclosed herein. For example, a clamping assembly mayinclude hinged plates configured for selective lateral deployment orother non-inflatable mechanisms may be employed. Moreover, the size,angles and/or curves of the various components described above may bemodified to better suit a particular surgical procedure. Therefore, theabove description should not be construed as limiting, but merely asexemplifications of various embodiments. Those skilled in the art willenvision other modifications within the scope and spirit of the claimsappended hereto.

What is claimed is:
 1. A surgical stapling apparatus, comprising: ahandle assembly; an elongate portion extending distally from the handleassembly; and an end effector disposed adjacent a distal portion of theelongate portion, the end effector comprising: an anvil assemblyincluding a fastener forming surface thereon; a cartridge assemblyincluding a fastener ejection surface thereon through which surgicalfasteners may be ejected, at least one of the cartridge assembly and theanvil assembly being movable with respect to the other between an openposition wherein the cartridge assembly is substantially spaced from theanvil assembly and a closed position where the cartridge assembly andthe anvil assembly are closer together; and a clamping assemblyincluding a first clamping surface deployable to extend laterally fromthe fastener forming surface of the anvil assembly, and a secondclamping surface deployable to extend laterally from the fastenerejection surface of the cartridge assembly such that, when deployed, thefirst and second clamping surfaces oppose one another when the cartridgeassembly is in the closed position.
 2. The surgical stapling apparatusaccording to claim 1, wherein a portion of the first clamping surface isdeployable to extend distally from the fastener forming surface of theanvil assembly, and the second clamping surface is deployable to extenddistally from the fastener ejection surface of the cartridge assembly.3. The surgical stapling apparatus according to claim 1, wherein theclamping assembly further comprises at least one fluid reservoiroperatively associated with the first and second clamping surfaces suchthat a fluid may be introduced into the fluid reservoir to deploy thefirst and second clamping surfaces.
 4. The surgical stapling apparatusaccording to claim 3, wherein an outer surface of the fluid reservoir isflexible.
 5. The surgical stapling apparatus according to claim 3,wherein the clamping assembly comprises distinct first and second fluidreservoirs operatively associated with the first and second clampingsurfaces respectively, such that the first and second clamping surfacesmay be deployed independently.
 6. The surgical stapling apparatusaccording to claim 1, wherein the first clamping surface defines agenerally U-shaped perimeter.
 7. The surgical stapling apparatusaccording to claim 1, wherein at least one of the first and secondclamping surfaces includes a wound treatment material.
 8. Anelectrosurgical apparatus for manipulating tissue, the apparatuscomprising: a handle assembly; a connector for connection to a source ofelectrosurgical energy; a tubular elongate portion extending distallyfrom the handle assembly and including a fluid conduit extending atleast partially therethrough; and an end effector coupled to a distalend of the tubular elongate portion, the end effector comprising: a pairof jaw members configured to move between an open configuration forreceiving tissue and a closed configuration for clamping the tissuebetween a pair of clamping surfaces on the jaw members; and a fluidreservoir in fluid communication with the fluid conduit, the fluidreservoir being inflatable to increase an effective clamping surfacearea of the jaw members.
 9. The surgical apparatus according to claim 8,wherein the reservoir extends laterally from tissue engaging surfaces ofthe end effector when the reservoir is inflated.